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May 31, 1997


he old man, well in his sixties, walked up the garden path towards the bungalow. It was a typical army bungalow, this one, with a huge verandah, 6-7 rooms and an unkempt garden in front.

The wooden gate which the man had walked through was almost always kept open, especially in the evenings when there would be many visitors, mostly patients, for Dr Jyoti, lieutenant colonel in the army and head of the spinal cord injury centre, Military Hospital, Khadki, Pune.

But this man was not a patient. Dr Jyoti could see that from where he was relaxing on the verandah after his evening rounds. Yet the face looked familiar; he had seen him somewhere... At the hospital? Most probably. He struggled to recollect.

As the old man strode nearer, the doctor remembered where he had met him. It was at the hospital. This was the man whom he had met that morning with Shamsher Singh, one of his patients. Singh had been under his treatment for quite a while -- the young soldier had injured himself in a vehicle accident and would never walk again. Dr Jyoti had operated on him twice and done all he could, but there was no chance of his recovering the use of his lower limbs. He was paralysed, a paraplegic for life.

Singh's wife -- an young lady all veiled -- had, for the first time since his admission in the MH, come down to visit. This was the man who had accompanied her, probably her father.

Dr Jyoti knew what the old man wanted. He wanted to know about his daughter's future -- he wanted him to say, "All right, your son-in-law will never walk again, so it is okay if you take her back." This was not the first time he was facing such a situation. Most of his patients' families behaved the same way -- once you became a paraplegic, your family didn't want you any more. Not really. That was one fact of life he had come to accept from his two-and-a-half decades as a spinal surgeon.

Dr Jyoti rose as his guest -- the old man was still in his rumpled clothes of the morning -- paused at the bottom of the steps leading to the verandah.

"Doctorsaab, what about my daughter?" The words were in Punjabi, in that curious dialect of the Kangra hills, very rustic.

"What about her?"

"Doctorsaab, that is what I am asking you. What about my daughter? She is only 17!" The old man shifted agitatedly.

"What do you want to know about her?"

""Why do you want me to spell out everything?" the man cried. "You know my daughter is just a child, she hasn't experienced anything in life, she doesn't know what life is... how can she live with an invalid?"

The doctor walked down the steps and placed his hand on the man's shoulder. "Look, old man," he said gently, "you know marriages are made in heaven. If He in heaven has decided your daughter's fate is this, what can we do? You can't help it, I can't help it -- it is the will of God."

He hoped the ploy would work -- this was his standard reply in such cases. What else could he say, anyway?

But the man was not calmed. "Saab, I have not seen God, you have not seen God, my 17-year-old daughter has not seen God. So please do not tell me about that. Tell me what I should do about my daughter? How can I leave her with this paralysed man?"

"Tell me, doctor," he continued, "if she were your daughter, would you leave her with him?"

Dr Jyoti had no answer. The old man turned on his heels and disappeared.

The next morning, Singh's wife -- who he had been told was here to stay -- disappeared from his bedside. And Singh sank steadily back into the depression he was gradually climbing out from.

Some weeks later, when Dr Jyoti walked into Singh's ward, he had a pleasant surprise. The invalid was sitting up in his bed and smiling -- with his wife, Asha, sitting demurely besides him. The girl had managed to persuade her parents to send her back.

Today, 14 years later, Singh and Asha are a very happy couple. They stay on the Paraplegics Rehabilitation Centre campus, in one of the 26 family accommodations available -- in a nice, neat home with a little garden and plenty of furniture -- and work in the same sheltered workshop. Evenings, like any other normal couple, they go out for walks or shopping.

"They are quite happy, these two," observed Dr Jyoti who has, since his retirement from the MH, taken over as the PRC's medical director. "Among my boys here , marriage is not at all uncommon -- in fact, five of my boys got married after their accident!"

All the family accommodation available at the centre has been taken. "Most of them were married before the paralysis. And their families have adjusted to it," Dr Jyoti says. "We encourage them to marry. With the advances in research today, they can have sex, even children."

"But how," he is often asked, "would a paraplegic, with no sensation in half his body, manage that?"

"Basically, sex is meant for satisfying the spouse," Jyoti replied. A drug, Pappaverine, can be used to achieve tumescence. "It enlarges the veins and increases the blood flow. It is injected at the base of the penis and the resultant erection will last for half an hour," he said.

"Initially, when the research started about 10 years ago, no one wanted to try it out. Now they have got over that -- and many make good use of it!" Jyoti smiles. Now he keeps a good supply of it at the centre. This drug too, as many others are, is supplied free to the inmates.

Other options are also available to a paraplegic. Like, for instance, the use of suction -- here vacuum suction is applied on the penis to increase the blood flow. Once it is erect, a rubber ring is slipped on at the base to prevent the blood from flowing back.

Like any normal couple, having a child is the dream of paraplegics. Today, with artificial insemination, this too is possible. "The only problem is that as paraplegics do not have any bladder control, it is difficult to extract semen." A technique to extract semen has now been perfected. An electrical stimulator is placed in the rectum and the the urinary passage is artificially blocked to prevent even a drop of urine from mixing with it -- or else, the sperms would be killed.

"When will this be available to the inmates?"

"First we need a urology lab for the insemination. We would need about Rs 60,000 for setting it up," Dr Jyoti said, "Plus the charges for the additional staff. I have already submitted a report. But..."

But, with the ongoing fund crunch which the centre is trying to tide over with private donations, the proposed project may hang fire. As would the dreams of many married paraplegics.

Shamsher Singh with wife, Asha

Lt Col (Dr) S P Jyoti, medical superintendent, PRC

Shamsher Singh and Asha on their regular evening walk


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